For Repeat Procedure, Turn to Modifiers 76 Or 77

Point to remember: When the physician carries out exactly the same procedure a couple of times, modifier 59 won't be applicable.

Here's a question: Is modifier 76 or 59 proper when the radiologist reviews two studies on the same date of service (DOS), but the scans don't merit the same codes?

Answer: Well, unless your payer tells you in a different way, go for modifiers 76 (Repeat procedure or service by same doctor or other qualified health care professional) and 77 (Repeat procedure or service by another doctor or other qualified health care professional) only when the provider(s) carry out the exact same exam twice.

First example: If a patient in the intensive care unit (ICU) has two single-view chest X-rays (71010, Radiologic examination, chest; single view, frontal) on the same day, use the second exam with modifier 76 or 77 (depending on whether both exams involved the same doctor).

Second example: If a patient has a complete ankle exam (73610, Radiologic examination, ankle; complete, minimum of three views) followed later in the day by a limited exam (73600, … two views) go for modifier 59 (Distinct procedural service) in order to tell the payer the provider carried out the exams in separate encounters.

Source URL :- http://www.supercoder.com/code-lookup/modifiers/

Catch this:

2011 CPT code changes the descriptors for modifiers 76 and 77 to clarify that the modifiers do not apply only to physician services. Other qualified health care professionals are now clearly included, as well. CPT made the same revision to modifier 78 (Unplanned return to the operating/ procedure room by the same doctor or other qualified health care professional following initial procedure for a related procedure during the postoperative period).